Single Payer, Up Close & Personal

Having shared the past week with family in Canada, I was hoping to employ memorable and penetrating insights from my sister, her husband, and their daughters in this piece, about the joys and frustrations of the Canadian health system. I was counting less on my mother, 91 years old and quite frail, to offer help in this way. I should note that Mom is still an American citizen, and that sis and husband emigrated from Illinois 40 years ago for reasons unrelated to Canada having single payer health.

My interview evoked a few interesting comments: how the federal monies are managed by the individual provinces, much like Medicaid, which means you get more care in Ontario, say, than in British Columbia where they all lived and which they claimed was “not the best”; how hospital coverage and primary care are great, with insurance costs (based on a sliding scale) never a burden (at least for them); how obtaining specialists and elective surgeries, and even basic testing, can be a slow process, always triaged so that the healthiest can wait a long time for care; how people with money to pay out of pocket get better care (they can go to the U.S, for one thing), and those who get their own testing can speed up the process; how everybody gets an annual fixed amount for chiropractors and massage therapy. They also noted a doctor shortage, especially outside of the cities, as doctors have left the country for better pay elsewhere.

My family all love their chiropractors, by the way, my nieces having benefitted since they were teens. It’s paid for, so why not try it? A remarkable health care “opportunity” , when you think about it. In the end, what may be most significant lies in things not said. That my nieces, now in their thirties, have not had to plan their lives and careers around seeking jobs with health benefits, a real freedom when one is young and trying to figure out what to do in life (my older niece teaches Flamenco dancing, for instance, not your usual job-with-benefits). In the end, my mother probably had the most to say, by example rather than words: as you might imagine, the lady has endured her share of medical crises over the past several years, and has always received whatever care was needed in a timely fashion. “Coverage” has never been an issue. And she is not Canadian. That’s a pretty impressive health system, whatever its shortcomings. Canadian enthusiasm for hockey is also very impressive (a lot of business meetings evidently got cancelled during the recent Olympics, for instance), but that’s another story.

John Dabrowski LICSW
Neponset Health Center
Geiger Gibson Community Health Center


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